Tag Archives: Referral

Kenya | MPDSR committees across all levels jointly tackle referral systems challenges

In 2016, nearly half of maternal deaths (48%)1 and almost a third of perinatal deaths (31%)2 occurring in health facilities in Bungoma County were referred from another facility. The facility level maternal and perinatal death reviews in the County, supported by the Maternal and Newborn Initiative (MANI) project highlighted multiple problems with the referral system, including:

  • Delays in the decision to refer clients
  • Inappropriate treatment prior to referral or lack of efforts to try to stabilise clients before transit (e.g. Administering magnesium sulphate to clients experiencing pre-eclampsia)
  • Referring facilities not calling ahead to enable referral facilities to prepare for receiving emergency cases
  • Referring facilities not sending completed referral slips or client history
  • Lack of (or delays in organising) ambulances, drivers, and/or fuel, especially at night
  • Lack of a nurse or clinician to accompany clients in ambulance
  • Emergency clients being dropped off alone at facility entrances.

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Emergency referral transport for maternal complication: lessons from the community based maternal death audits in Unnao district, Uttar Pradesh, India

This article by Sunil Saksena Raj and colleagues, published by the International Journal of Health Policy and Management in January 2015, presents the findings of verbal autopsies carried out in Unnao District between 2009 and 2010. The findings point to the need to improve the inter-facility referral system.